Medical and surgical reports . 40 years, suffered 2 years from violent spasms of pain inthe right arm with spasmodic drawing up of the arm. This followed remotely from ashell wound of the shoulder during the war but more immediately from a long exposureto cold in an ice refrigerator in which he wras renewing a zinc lining. He had hadnerve stretching, nerve section and finally a low and a high amputation near theshoulder—before he came to me. He had acquired morphine habit mildly. thought the pain largely delusional with an acquired morphine habit. Allother neurologists regarded it as
Medical and surgical reports . 40 years, suffered 2 years from violent spasms of pain inthe right arm with spasmodic drawing up of the arm. This followed remotely from ashell wound of the shoulder during the war but more immediately from a long exposureto cold in an ice refrigerator in which he wras renewing a zinc lining. He had hadnerve stretching, nerve section and finally a low and a high amputation near theshoulder—before he came to me. He had acquired morphine habit mildly. thought the pain largely delusional with an acquired morphine habit. Allother neurologists regarded it as due to ascending neuritis. The man gave evidenceevery five or ten minutes of sharp pain in the stump of the amputated arm, usuallycausing him to double over and grasp the stump with his left hand. When asked todescribe the attack, says it jumps and the stump draws to his side when the pain shootsinto his hand and fingers, as if they were still on, and he can feel them all drawn avers that it keeps up during the Incision for resection of posterior roots of spinal nerves. RESECTION OF SPINAL NERVE ROOTS 17 Dr. Dana, Starr and others diagnosed neuritis and Dr. Dana devised the rootsection operation. It might be called Rhizotomy. I divided the 6th and 7thnerves on emerging from the dura but inside the vertebral canal. Pain was notmeasurably relieved. Two days later I laid the patient face down under a brightlight and on removing the packing from the wound, split up the dura and picked upand cut the posterior roots only of the 7th and 8th nerves. As the 6th had beenincluded in the section of the whole nerve outside the dura, it was evident Ihad divided the sensory roots of the 6th, 7th and 8th, which distribute to thehand and forearm. During the operation Dr. Dana frequently applied a fine electri-cal stimulation to the roots before cutting, thus identifying muscular seems not to have been done in other cases, but may wisely be used in doubtfulcirc
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